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    By Robert H. Osher, MD
    Video Journal of Cataract and Refractive Surgery
    Cataract/Anterior Segment

    Dr. Robert H. Osher describes a 65-year-old patient with stable keratoconus and 5D of astigmatism who presents for cataract surgery. Typically, he would implant a monofocal IOL in such a patient. The choice of a toric IOL appears counterintuitive as the patient’s astigmatism isn’t symmetrical. But in older patients with stable disease, he shows good outcomes are possible. At 1 day postop, this patient could see 20/30 uncorrected.